Specific aims for the five year period include initiating and completing a study of an experimental treatment for alcoholics who have recently had a liver transplant. Naltrexone, an opiate receptor antagonist, will be compared to placebo in a double blind clinical trial. A third comparison group will be asked to attend AA meetings only. A secondary aim of this project will be to ascertain information which may suggest whether predictive risk factors which have been associated with relapse in non transplanted alcoholics also predicts relapse in alcoholics who have had liver transplants. Another secondary aim is to study the effects of Motivational Enhancement Therapy (MET) on alcohol relapse rates and biopsychosocial functioning following a liver transplant. We also plan to study whether a new blood biochemical measure, the Carbohydrate Deficient Transferrin (CDT) can more accurately assess the relapse rates of alcoholics who have had liver transplants when compared to standard methods such as alcohol breathalyzer tests, urine alcohol tests, collateral and self reporting measures.There will be a collaborative project with Dr. M.J. Kreek at the Rockefeller Institute to study naltrexone's effects on Natural Killer cell activity. A final aim of this project will be to compare preliminary measures of cost effectiveness in the three groups by measuring quality of life, occupational histories, and psychiatric severity.